Abstract

Bronchiolitis due to respiratory syncytial virus (RSV) or non-RSV agents is a health-menacing lower respiratory tract (LRT) disease of infants. Whereas RSV causes more severe disease than other viral agents may, genus-dominant fecal microbiota profiles have been identified in US hospitalized infants with bronchiolitis. We investigated the fecal microbiota composition of infants admitted to an Italian hospital with acute RSV (25/37 [67.6%]; group I) or non-RSV (12/37 [32.4%]; group II) bronchiolitis, and the relationship of fecal microbiota characteristics with the clinical characteristics of infants. Group I and group II infants differed significantly (24/25 [96.0%] versus 5/12 [41.7%]; P = 0.001) regarding 90% oxygen saturation (SpO2), which is an increased respiratory effort hallmark. Accordingly, impaired feeding in infants from group I was significantly more frequent than in infants from group II (19/25 [76.0%] versus 4/12 [33.3%]; P = 0.04). Conversely, the median (IQR) length of stay was not significantly different between the two groups (seven [3–14] for group I versus five [5–10] for group II; P = 0.11). The 16S ribosomal RNA V3–V4 region amplification of infants’ fecal samples resulted in 299 annotated amplicon sequence variants. Based on alpha- and beta-diversity microbiota downstream analyses, group I and group II infants had similar bacterial communities in their samples. Additionally, comparing infants having <90% SpO2 (n = 29) with infants having ≥90% SpO2 (n = 8) showed that well-known dominant genera (Bacteroides, Bifidobacterium, Escherichia/Shigella, and Enterobacter/Veillonella) were differently, but not significantly (P = 0.44, P = 0.71, P = 0.98, and P = 0.41, respectively) abundant between the two subgroups. Overall, we showed that, regardless of RSV or non-RSV bronchiolitis etiology, no fecal microbiota-composing bacteria could be associated with the severity of acute bronchiolitis in infants. Larger and longitudinally conducted studies will be necessary to confirm these findings.

Highlights

  • Bronchiolitis is a disease of the lower respiratory tract of infants and young children that, despite being characterized by small airway obstruction, can progress to pneumonia, respiratory failure, apnea, or death (Meissner, 2016)

  • Infants had presented to the emergency department with severe illness symptoms such as dyspnea (24/25 [96.0%] versus 7/12 [58.3%]) or oxygen saturation

  • Our fecal microbiota investigation of hospitalized infants with acute bronchiolitis did not show any statistically significant difference in their bacterial community related to the respiratory syncytial virus (RSV) or non-RSV etiology

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Summary

Introduction

Bronchiolitis is a disease of the lower respiratory tract of infants and young children that, despite being characterized by small airway obstruction, can progress to pneumonia, respiratory failure, apnea, or death (Meissner, 2016). Based on recently published data, bronchiolitis accounted for 313,566 emergency department visits between 2006 and 2010 in the United States (4.3% involved children were

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